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Tell us about your organization.

Organization Information Why does Checklick need this information? It's important for us to be able to contact your organization if you decide to licence another organization's checklist or offer to licence your own checklists to other organizations.

Organization Name

Contact Name

Organization Email

Organization Phone

Organization Address

Mandatory Personal Information Why does Checklick need email and birthdate? Checklick is often used by young people who might be using their parents' email addresses. Because of this, Checklick lets people in the same family use the same email address for each of their accounts. This means Checklick needs some extra information (birthdate and email) to make it easier to uniquely identify people.

First Name

Last Name

Email

Participant's Birthdate

Additional Personal Information

Address

Gender

Language

Phone

Emergency Contact Person

Emergency Contact Instructions

Health Notes

Username and Password (Optional)

Create a username

Create a password

Retype your new password

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